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- Multimorbidity daily life activities and socio-economic classification in the Central Portugal primary health care setting: an observational studyPublication . Santiago, Luiz Miguel de Mendonça Soares; Prazeres, José Filipe Chaves Pereira; Boto, Tânia; Mauricio, Katia; Rosendo, Inês; Simões, José Augusto RodriguesBackground. Multimorbidity (MM) is associated with decreased quality of life, mainly due to decreased functional capacity and increased use of health care. Objectives. Evaluate the prevalence of MM in older people of Central Portugal and understand the impact of MM on daily life activities (DLA) and how socioeconomic level influenced prevalence of MM. Material and methods. Observational study of data on age, sex, number of ICPC2 codes and Barthel (Bt) and Graffar (Gr) Indexes in clinical records of all aged between 65 to 99 years enrolled in the Health Centers of the Central Region of Portugal. The Bt was used to assess the dependence on DLA and the Gr the socioeconomic level. Results. Population of 190025, mean age of 80.16± 8.03 years. MM prevalence of 80% out of which, 52.9% were female and the majority was aged between 76-85 years (39.1%). Average number of health problems of 8.7 problems for males and 9.5 for females. The Bt and Gr Indexes filling for the studied sample were of, Barthel 7.4% and Graffar 4,9%. Older people without MM have higher dependency rates than those with MM (total dependence 7.4% vs 6.2% and severe dependence 20.1% vs 9.6%). MM in older people are mainly in the middle (55.3% vs 27.5%) and low (31.8% vs 19.6%) Graffar class, while the older people without MM are mainly at middle to upper (35.3%) and upper (17.6%) Graffar classes. Conclusions. Multimorbidity is mainly associated with lower social classes. Dependence for DLA appears unrelated to MM. Multimorbidity persons need special attention, based on socio-economic contexts.
- Comparing empathy in medical students of two Portuguese medicine schoolsPublication . Santiago, Luiz Miguel de Mendonça Soares; Rosendo, Inês; Coutinho, Mona-Lisa; Mauricio, Katia; Neto, Isabel; Simões, José Augusto RodriguesBackground Empathy is paramount in the doctor-patient relationship being a comprehensive and multidimensional concept. Self-ratings of empathy change across the years of medical education only when the Jefferson Scale of Physicians Empathy is used, with a worrying decrease being found throughout the years in Medicine Schools. As there are only few studies on the factors influencing medical student’s empathy, particularly of the curricular model, this study aimed to compare the levels of empathy of medicine students of two Schools with different curricular models in central Portugal, the Faculty of Medicine - University of Coimbra (FMUC) and the Faculty of Health Sciences - University of Beira Interior (FCS-UBI). Methods Cross-sectional observational study with the Jefferson Scale of Physician Empathy – students’ Portuguese version (JSPE – spv) to 1st, 3rd and 6th year students of the 2017/2018 academic year with descriptive and inferential statistical analysis (p < 0.05). Results Size representative sample of 795 students. Higher total empathy score (TES) (p = 0.008) and “Perspective taking” (p = 0.001) in FCS-UBI were found. JSPE-TES was higher in FCS-UBI, 3rd year (p = 0.038). Higher FCS-UBI “Perspective taking” in the 1st year (p = 0.030) and 6th year (p = 0.044), for “Compassionate care” in the 3rd (p = 0.019) and for “Standing in the patient’s shoes” in the 1st year (p = 0.018) and in FMUC for “Compassionate care” in the 1st year (p = 0.037) and the “Standing in the patient’s shoes” in year 3 (p = 0.002) were found. Higher levels of empathy were found in FCS-UBI female students, for JSPE-TES (p = 0.045) and “Perspective taking” (p = 0.001). Conclusion Higher empathy levels in FCS-UBI were found, with different results in the third year suggesting influence of the medical course teaching characteristics between the two Medicine schools, student’s empathy levels being higher when earlier and more intense contact with patients accompanied by skilled tutors was developed.
- Communication and health: doctor-patient relationship in patients with multimorbidity, an exploratory studyPublication . Simões, José Augusto Rodrigues; Alberto, Kathleen; Simões, Pedro Augusto Gomes Rodrigues Marques; Mauricio, Katia; Rosendo, Inês; Santiago, Luiz Miguel de Mendonça SoaresBackground. With the increase of average life expectancy and the aging of the population, an increase in multimorbidity has also been observed. Effective communication in the doctor–patient relationship is directly related to the promotion of health of patents with multimorbidity. One of the fundamental foundations of this doctor-patient relationship is the physician’s ability to establish an empathic relationship with the patent. Objectives. The objective of this study is to compare Family Medicine consultations and Hospital consultations in terms of empathic communication and the doctor-patient relationship in patents with multimorbidity. Material and methods. An exploratory observational cross-sectional study was carried out using elderly people with multimorbidity and applying the JSPE scale. Statistical analysis was performed using descriptive statistics and the non-parametric Mann–Whitney u test. Results. For all questions on the JSPE scale, the family physician scored higher than the hospital physician. Between the specialties, statistically significant differences were obtained. Conclusions. The differences between Family Medicine consultations and Hospital consultations has an impact on the results of the medical empathy felt by the patents. Other studies demonstrate the importance of empathy in the doctor-patient relationship, and in this study, we concluded that there is a greater degree of empathy felt by the patients in Family Medicine consultations compared to the lower degree of empathy felt by the patents in Hospital consultations.